I would think so because those are two different procedures for the same body part/system, even though I'm sure an insurance company would argue that they are basically the same thing since the real difference is that one is an echocardiogram and the other is an electrocardiogram.

Have you tried submitting the claim with mod -51?

Oh.... and wouldn't it be nice to be able to bold the differences like I did to show an insurance company that would argue that the two tests are basically the same?

I have never used a -51 on the 93018 when submitting with 93350. I use the -26 on the 93350 and no modifier on the 93018. I am assuming that you are doing the stress echocardiogram in the hospital or outpatient testing center setting. This is how I bill:
93350 -26
93320 -26
93325 -26
93016
93018

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